Population ageing is a demographic revolution that is happening in all regions and countries at various levels of development, and it should be celebrated. The speed and timing of fertility and mortality transition definitely underlie demographic changes. The process of ageing has been taking place at a much faster rate in Asia than in the European countries. Before becoming rich, our nations emerge as ageing economies.
Factors like living arrangements, access to occupational pension, social security, health care and accessibility of kin, and other social networks and mechanisms for care and support, influence the elderly’s quality of life. As per the 2011 Census, the average size of Indian households is 4.5 persons and the average number of elderly persons in each household is 2.4. Of the 248.8 million households in India, 31.3 per cent have at least one elderly person. About 4.1 per cent are elderly-alone or all-elderly households.
About 27.2 per cent households have elderly persons living with adult members. The remaining 68.7 per cent households have no elderly member to worry about. In other words, more than half of the Indian households are without grandparents, which makes an intergenerational gap and the conventional dependency in these households nil, which may strengthen the fiscal capacity of the working age population with larger savings and investment.
Since people are living longer, they are expected to face the need to care for the very old. On an average, an elderly person is expected to live about 15 to 20 years, depending upon the state where he or she lives. The potential support ratio (PSR) indicates the old-age dependency burden on potential workers. According to this ratio, every eighth working Indian will have to take care of one elderly person in 2011. By 2051, the PSR for India is projected to fall to four working-age persons and in 2101, it will be two working-age persons.
A significant percentage of the elderly are still working for their livelihood due to inadequate social security or universal basic income. The elderly comprise about nine per cent of the total workers in India. Among the total elderly, 39.8 per cent are main or marginal workers and a majority of them are males. About one fifth of the very old (80+) among the elderly are still working.
However, there is a very significant level of non-workers among the elderly and hence their dependency on the working population is unavoidable. It is interesting to note that, unlike the male elderly, the work participation rate is increasing among the female elderly as the years go by. According to the 2011 Census, there were 26.8 million disabled people living in India. Among them, the elderly accounted for 20.2 per cent and most were women. Cases of severe disabilities point to the requirement for long-term care (LTC) and rehabilitation services.
The data on different types of illnesses among the elderly in India establish that cardiovascular, musculoskeletal, respiratory, infections and endocrine disorders are high in rural areas, while only cardiovascular and endocrine disorders are high in urban areas (National Sample Survey Office, 2014). While cardiovascular and endocrine disorders can cause an increase in high health expenditure, musculoskeletal ailments can lead to functional limitations and be the cause for premature withdrawal from the workforce. These conditions point to the need for economic assistance and social care.
Then there’s the issue of physical mobility. Elderly persons who are bedridden, need intense caregiving as they require help with all their activities of daily living (ADL) and may suffer from incontinence, which would aggravate the caregiver’s burden. The economic and social costs of hospitalisation require serious attention. When India grows old, it is important to make better use of the longer life span rather than viewing ageing as a dilemma. When people live longer, it offers society a chance to reap a longevity dividend, by recognising older people as a resource and not as a burden.
Due to a shift from joint or large family models, it is likely that the elderly may get less attention in the future. Therefore, an individual must have adequate savings to sustain and maintain a decent post-retirement lifestyle. Nobody can escape the reality of ageing. So the young today should be focused on their future prospects as well.
(The author is a professor at the Centre for Development Studies, Kerala)
